Various types of devices have been suggested for removal of intraluminal occlusions. Generally, these devices may be classified according to the following aspects:
(a) The manner by which occluding tissues are removed, e.g., the use of mechanical cutters, lasers, ultrasonic devices, fluid jets, etc. PA1 (b) The manner by which energy is transmitted to the cutting head, e.g., via flexible drive shafts, fluid power, electrical wires, etc. PA1 (c) The manner by which loosened tissue debris is removed, e.g., collecting the tissue debris in a collecting chamber next to the cutting head, aspirating the tissue fragments, fragmenting the tissue to very small particles, etc. PA1 a catheter having a distal end for insertion into a patient and a proximal end; PA1 a distal piston located within the distal end of the catheter for simultaneous longitudinal and rotational movement therein, the distal piston including a closed wave-shaped groove in a circumferential surface thereof which receives at least one stationary pin which is fixed to an inner portion of the distal end of the catheter and; PA1 a cutting head, the cutting head being attached to the distal piston for simultaneous longitudinal and rotational movement together with the distal piston. PA1 providing a catheter having a distal end for insertion into a patient with a cutting head for simultaneous longitudinal and rotational movement; PA1 inserting the distal end of the catheter into a lumen of a patient while maintaining the cutting head within the distal end of the catheter; PA1 positioning the distal end of the catheter near an object to be removed and; PA1 causing the cutting head to simultaneously move in both a longitudinal and a rotational movement so as to extend from the distal end of the catheter and cut the object to be removed.
The following U.S. patents are believed to exemplify state-of-the-art surgical catheter devices.
U.S. Pat. No. 4,316,465 to Dotson discloses an ophthalmic cutter that comprises a driving device having a helical groove and helical ridges cooperating with the groove. A cutting device is connected to the driving device to sever any tissue which extends through an aspiration port of the aspiration needle.
U.S. Pat. No. 4,324,243 to Helfgott et al discloses an apparatus and process for aspirating and evacuating a pneumatically operated surgical instrument. A series of pneumatic pulses are generated and transmitted to a piston of a charging assembly and the surgical instrument to cause a hollow tube of the instrument to move toward the distal end of a cutting tube in a cutting stroke.
U.S. Pat. No. 4,674,500 to DeSatnick discloses the use of a protective sheath for a cutting blade. The blade remains in the sheath until ready for use.
U.S. Pat. No. 4,749,376 to Kensey et al discloses a reciprocating working head catheter. The catheter comprises a tubular body or jacket having a drive and a movable working head. The drive includes a drive wire that extends from the proximal end located outside the patient to the motion translation means. The cable is rotated at high speeds and the motion translation means converts the rotation of the drive cable to a rotating reciprocating motion of the working head.
U.S. Pat. No. 4,790,813 to Kensey discloses a catheter having a working head which is adapted to be rotated by a turbine drive while the head is advanced into a restriction in a passageway. The turbine includes structure to coaxially supply a drive fluid through a central passage to a rotatable cutting head or turbine head which includes turbine blades.
U.S. Pat. No. 4,819,635 to Shapiro discloses a tubular microsurgery cutting apparatus that includes an outer tubular member having an open end fixed to a housing of the driving end. An inner tubular sleeve has an open end and a cutting end that reciprocates within the tube. Reciprocation is produced by a piston which is driven by a source of pulsing air supplied through end cap through a tube.
U.S. Pat. No. 4,850,957 to Summers discloses an atherectomy catheter having an outer catheter tube and an inner catheter tube. A hydraulic motor is housed within the inner catheter tube and includes a cutting element connected to a drive shaft of the hydraulic motor. Fluid under pressure is forced into a stator cavity to provide power to turn or rotate a rotor.
U.S. Pat. No. 4,957,482 to Shiber discloses an atherectomy system for cutting, ingesting and removing obstructions from within an artery. A flexible catheter is disposed over a flexible guide wire which is insertable into an artery. A hollow blade having teeth is provided at the distal end of the catheter. The catheter is rotated by a motor coupled to the catheter through a hub and belt.
U.S. Pat. No. 5,024,651 to Shiber discloses an atherectomy system having a rotary flexible catheter for coring and ingesting obstructions. A flexible rotary-catheter has coring means at its distal end. The catheter is slidably disposed in a sleeve. The sleeve has a window region near its distal end. The sleeve defines in the vessel a trajectory for the coring means to move along. Negative pressure for aspirating cut material can be applied through a rotary joint.
U.S. Pat. No. 5,047,008 to de Juan et al discloses a vitrectomy probe for removing vitreous materials having a blade which is located on the outer end of a tubular member which is attached to the end of a suction outlet tube. The blade is reciprocated by injecting pulsating pressurized fluid through a fluid inlet tube and port 22 into chamber 47. The pulses cause a diaphragm to push against a retainer connected to a suction outlet tube. The retainer and suction tube are urged away from the fluid chamber toward a stop ring causing a spring to be compressed and inner tubular member with blade to slide toward cutting position.
The present invention is directed to a catheter device for the removal of intraluminal occlusions which provides particular advantages over the prior art as discussed below.